Flaxseed with Latin name of Linum usitatissimum, meaning very useful, is a functional food due to its nutritional characteristics. Flaxseed is a rich plant source of polyunsaturated fatty acids especially a linolenic acid (ALA), soluble and insoluble dietary fibers, phytoestrogenic lignans, proteins with a high coefficient of digestibility and biological value and variety of antioxidants and phytoestrogens. we assumed that supplementation with flaxseed may act as a novel adjunctive therapeutic strategy for patients with non-alcoholic fatty liver disease.

A two-arm randomized open labeled controlled clinical trial was conducted on 50 patients with non-alcoholic fatty liver disease (NAFLD). Participants were assigned to take either a lifestyle modification, or modification +30 g/day brown milled flaxseed for 12 weeks.

At the end of the treatment, the transient elastography results showed a significant improvement within and between both groups; the mean reduction in fibrosis score in the flaxseed group was significantly greater than in control group (1.26 versus 0.78; p = 0.013), similarly as steatosis score (47 versus 15.47; p = 0.02). In the flaxseed group, 46% had a 1-level and 12% had 2-level reduction in their steatosis score, but no grade reduction was seen in control group. Significantly improvements in serum liver enzymes were observed in both groups of treatment compared with pre-treatment values, with a significantly greater reduction in flaxseed group in comparison to control group. Also, we found a significant reduction in serum levels of some inflammatory biomarkers in the intervention group.

In conclusion, this randomized controlled clinical trial found some evidence that flaxseed supplementation in combination with a lifestyle modification is more effective than lifestyle modification alone for treatment of NAFLD, at least partially through amelioration of insulin resistance, hyperlipidemia and inflammatory markers